射频消融术和腹腔镜手术治疗原发性小肝癌的前瞻性对照研究

目的探讨射频消融术与腹腔镜手术治疗原发性小肝癌的临床疗效和安全性。 方法选取2013年6月至2016年6月105例原发性小肝癌患者为研究对象，将患者按住院号用随机数字表法随机分为射频消融组54例、腹腔镜组51例，采用SPSS19.0软件包对数据进行分析，术中术后和肝功能情况采用( ±s)描述，组间比较采用独立t检验；并发症组间比较采用χ²检验；P<0.05为差异有统计学意义。 结果射频消融组的手术时间、术中出血量、术中输液量、住院日优于腹腔镜手术组(P<0.05)；两组在术后1个月的ALT和AST水平均较术前降低(P<0.05)，射频消融组显著低于腹腔镜组(P<0.05)；所有患者术后随访1～3年，射频消融组在术后的无瘤生存时间和总体生存时间显著优于腹腔镜手术组(P<0.05)；两组术后并发症差异无统计学意义(P>0.05)。 结论和腹腔镜手术比较，射频消融术在原发性小肝癌治疗上安全性高，术后肝功能恢复快，可以提高患者术后生存质量。

A prospective control study of radiofrequency ablation and laparoscopic surgery in the treatment of primary small liver cancer

ObjectiveTo explore the clinical efficacy and safety of radiofrequency ablation and laparoscopic surgery in the treatment of primary small liver cancer. Methods105 cases of primary small liver cancer from June 2013 to June 2016 in our hospital were selected as the research object, the patients were randomly divided into radiofrequency ablation group (54 cases) and laparoscopic surgery group (51 cases). SPSS19.0 was used to analyzed the difference between the two groups with surgery and preoperative and postoperative liver function, survival time and complications of surgery. P<0.05 indicated the difference was statistically significant. ResultsThe operation time, blood loss, infusion volume, hospitalization time in the radiofrequency ablation group was significantly lower than those in the laparoscopic surgery group (P< 0.05). the ALT and AST levels at 1 month after operation were significantly decreased in the radiofrequency ablation group than those in the laparoscopic surgery group (P<0.05). All 105 patients were followed up for 1~3 years. The tumor free survival time and overall survival time was significantly better in the radiofrequency ablation group than those in the laparoscopic surgery group (P<0.05). There was no significant difference between the two groups in complications (P>0.05). ConclusionCompared with laparoscopic surgery, radiofrequency ablation in small hepatocellular carcinoma treatment is safe, which can promote the recovery of liver function, improve the quality of life of patients.